- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,130.40 / $26,561.40 / $44,846.20
| Facility | | $12,130.40 | $26,561.40 | $44,846.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,780.59 / $43,007.63 / $55,282.85
| Facility | | $27,780.59 | $43,007.63 | $55,282.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,478.81 / $37,863.67 / $55,581.75
| Facility | | $26,478.81 | $37,863.67 | $55,581.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,484.63 / $37,440.19 / $78,513.27
| Facility | | $19,484.63 | $37,440.19 | $78,513.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,259.63 / $14,259.63 / $14,259.63
| Facility | | $14,259.63 | $14,259.63 | $14,259.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,478.81 / $41,224.46 / $55,888.17
| Facility | | $26,478.81 | $41,224.46 | $55,888.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,671.28 / $34,865.32 / $52,413.83
| Facility | | $7,671.28 | $34,865.32 | $52,413.83 |